User-Centered Design of a Gamified Mental Health App for Adolescents in Sub-Saharan Africa: Multicycle Usability Testing Study.

Autor:	Pozuelo JR; Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.; Department of Psychiatry, University of Oxford, Oxford, United Kingdom.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Moffett BD; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Davis M; Mind Ease, London, United Kingdom., Stein A; Department of Psychiatry, University of Oxford, Oxford, United Kingdom.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Africa Health Research Institute, KwaZulu Natal, South Africa., Cohen H; Lincoln College, University of Oxford, Oxford, United Kingdom., Craske MG; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States., Maritze M; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Makhubela P; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Nabulumba C; BRAC, Kampala, Uganda., Sikoti D; BRAC, Kampala, Uganda., Kahn K; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Sodi T; SAMRC-DSI/NRF-UL SARChI Research Chair in Mental Health and Society, University of Limpopo, Limpopo, South Africa., van Heerden A; Center for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South Africa.; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., O'Mahen HA; Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, United Kingdom.
Jazyk:	angličtina
Zdroj:	JMIR formative research [JMIR Form Res] 2023 Nov 30; Vol. 7, pp. e51423. Date of Electronic Publication: 2023 Nov 30.
DOI:	10.2196/51423
Abstrakt:	Background: There is an urgent need for scalable psychological treatments to address adolescent depression in low-resource settings. Digital mental health interventions have many potential advantages, but few have been specifically designed for or rigorously evaluated with adolescents in sub-Saharan Africa. Objective: This study had 2 main objectives. The first was to describe the user-centered development of a smartphone app that delivers behavioral activation (BA) to treat depression among adolescents in rural South Africa and Uganda. The second was to summarize the findings from multicycle usability testing. Methods: An iterative user-centered agile design approach was used to co-design the app to ensure that it was engaging, culturally relevant, and usable for the target populations. An array of qualitative methods, including focus group discussions, in-depth individual interviews, participatory workshops, usability testing, and extensive expert consultation, was used to iteratively refine the app throughout each phase of development. Results: A total of 160 adolescents from rural South Africa and Uganda were involved in the development process. The app was built to be consistent with the principles of BA and supported by brief weekly phone calls from peer mentors who would help users overcome barriers to engagement. Drawing on the findings of the formative work, we applied a narrative game format to develop the Kuamsha app. This approach taught the principles of BA using storytelling techniques and game design elements. The stories were developed collaboratively with adolescents from the study sites and included decision points that allowed users to shape the narrative, character personalization, in-app points, and notifications. Each story consists of 6 modules ("episodes") played in sequential order, and each covers different BA skills. Between modules, users were encouraged to work on weekly activities and report on their progress and mood as they completed these activities. The results of the multicycle usability testing showed that the Kuamsha app was acceptable in terms of usability and engagement. Conclusions: The Kuamsha app uniquely delivered BA for adolescent depression via an interactive narrative game format tailored to the South African and Ugandan contexts. Further studies are currently underway to examine the intervention's feasibility, acceptability, and efficacy in reducing depressive symptoms. (©Julia R Pozuelo, Bianca D Moffett, Meghan Davis, Alan Stein, Halley Cohen, Michelle G Craske, Meriam Maritze, Princess Makhubela, Christine Nabulumba, Doreen Sikoti, Kathleen Kahn, Tholene Sodi, DoBAt & Ebikolwa Consortium, Alastair van Heerden, Heather A O’Mahen. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.11.2023.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu